Section 17. Infectious Diseases >
Part 2. Infections of Organ Systems >
Chapter 234. Bone, Joint, Soft Tissue Infections
OsteomyelitisRobin B. Churchill and Blanca E. Gonzalez
Topics Discussed: arthritis, acute bacterial; arthrocentesis; bacterial arthritis; biopsy of bone; bone scan; diagnostic radiologic examination; discitis; infectious diseases; joint infections; magnetic resonance imaging; musculoskeletal system; osteomyelitis; osteomyelitis of pelvic region; osteomyelitis of vertebra; osteomyelitis, bacterial; osteomyelitis, chronic; osteomyelitis, hematogenous, acute; osteomyelitis, pyogenic, acute; osteomyelitis, staphylococcus aureus; sickle cell anemia; skin diseases, infectious; soft tissue infections.
Sections: Skin and Soft Tissue Infections, References.
Excerpt:"Acute hematogenous osteomyelitis (AHO) is a disease of young
children. The majority of cases occur before 5 years of age with
up to one third occurring in children younger than 2 years of age.1,2 There
is a male predilection, with males outnumbering females in most
published series by approximately 2:1.1-5 However,
in a more recently published series, males accounted for 52% of
the patients.6 There is frequently a history of some
type of minor blunt trauma2,7 or intercurrent illness,
such as an upper respiratory tract infection.8 Other
risk factors for AHO include immunodeficiency states, sickle cell
anemia, and indwelling vascular catheters. In some areas of the
United States, the incidence of osteoarticular diseases including
AHO has increased with the emergence of community-associated methicillin-resistant Staphylococcus
aureus (CA-MRSA).6The predominant organism in acute hematogenous osteomyelitis
in all age groups is Staphylococcus aureus, accounting for
50% to 90% of cases.17,18 In
recent years, CA-MRSA has emerged as a significant pathogen in AHO.6,17,19 The
majority of strains circulating in the community harbor the genes
encoding for the exotoxin Panton Valentin leukocidin (PVL). This
important virulence factor has been associated with severe musculoskeletal
infections in children.18,20 Studies have shown
that osteomyelitis caused by PVL-positive S aureus strains..."
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